Chinese Medical E-ournals Database

Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition) ›› 2017, Vol. 13 ›› Issue (05): 558 -562. doi: 10.3877/cma.j.issn.1673-5250.2017.05.010

Special Issue:

Original Article

Echocardiogram in coronary artery fistula of children: application values

Dan Liu1, Jiao Chen1, Nan Guo1, Qi Zhu1, Yimin Hua2, Hong Luo1,()   

  1. 1. Department of Ultrasound, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education
    2. Department of Pediatric Cardiology, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
  • Received:2017-04-14 Revised:2017-08-01 Published:2017-10-01
  • Corresponding author: Hong Luo
  • About author:
    Corresponding author: Luo Hong, Email:
Objective

To explore the clinical value of color Doppler echocardiography in diagnosis of pediatric coronary artery fistula (CAF).

Methods

A total of 20 CAF children who diagnosed by echocardiography from January 2011 to May 2017 at West China Second Hospital, Sichuan University were enrolled in this study. The echocardiograms, findings of coronary arteriography and outcomes of percutaneous interventional therapy of 20 CAF children were retrospectively analyzed.

Results

① Echocardiography results showed 7 cases of right coronary artery to right ventricular fistula, 4 cases of left coronary to right ventricular fistula, 3 cases of left coronary to right atrium fistula, 2 cases of left coronary to pulmonary artery fistula, 2 cases of right coronary to artery right atrium fistula, 1 case of left coronary to left ventricular fistula, 1 case of right coronary artery to right ventricular fistula combined with left coronary pulmonary artery fistula. ②Dilated coronary artery and abnormal flow signal in ecstatic coronay arteries and fistulas were typical echocardiographic features of CAF. ③ The ultrasonic diagnosis of 18 patients was in line with findings of coronary arteriography, 16 of them underwent interventional therapy successfully, and another 2 patients failed. Surgery procedure were recommended to the 2 patients.

Conclusion

Echocardiography plays an important role in diagnosis and therapeutic evaluation of CAF in children.

图1 1例右冠状动脉-右心室瘘患儿的二维、彩色及频谱多普勒图像(图1A:大动脉短轴切面显示扩张的右冠状动脉;图1B:彩色多普勒超声结果显示扩张右冠状动脉内充满花色血流信号;图1C:频谱多普勒超声结果显示于右心室壁探及双期血流频谱)
表1 20例冠状动脉瘘患儿超声心动图检查结果和介入封堵术后检查结果对照
图2 1例右冠状动脉-右心室瘘患儿在介入封堵术前及术后的超声心动图图像(图2A:全程扩张及显色的右冠状动脉;图2B:追踪探查于右心室壁查见瘘口;图2C:介入封堵治疗后,封堵器位置正常,分流消失)
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